Shengxiang Ao1, Wenjie Zheng1, Junlong Wu1, Yu Tang1, Chao Zhang1, Yue Zhou2, Changqing Li3. 1. Department of Orthopaedics, The Second Affiliated Xinqiao Hospital of Army Medical University, 183 Xinqiao Street, Shapingba District, Chongqing, 400037, China. 2. Department of Orthopaedics, The Second Affiliated Xinqiao Hospital of Army Medical University, 183 Xinqiao Street, Shapingba District, Chongqing, 400037, China. Electronic address: happyzhou@vip.163.com. 3. Department of Orthopaedics, The Second Affiliated Xinqiao Hospital of Army Medical University, 183 Xinqiao Street, Shapingba District, Chongqing, 400037, China. Electronic address: changqli@163.com.
Abstract
BACKGROUND: Percutaneous endoscopic transforaminal lumbar interbody fusion (PETLIF) has been used in the treatment of lumbar degenerative diseases, as a novel minimally invasive technique. OBJECTIVES: To compare the surgical trauma and the medium-short term postoperative outcomes of PETLIF and traditional minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). METHODS: From April to August of 2018, 75 patients with lumbar degenerative diseases received PETLIF (Group PE, 35 cases) or MIS-TLIF (Group MIS, 40 cases) were enrolled in the prospective cohort study. We recorded the serum creatine kinase (CK) and C-reactive protein (CRP), blood loss, visual analog scale (VAS), Oswestry Disability Index (ODI), modified Macnab criteria score, complications, and fusion rates of the 2 groups. RESULTS: There were significant reductions in CRP (P = 0.002) on postoperative day (POD) 3, and CK (P = 0.011) on POD 1 for Group PE than Group MIS. The mean true total blood loss (P < 0.001), intraoperative blood loss (P < 0.001), postoperative drains (P < 0.001), and hidden blood (P = 0.020) in the Group PE were significantly less compared with Group MIS. The VAS score for low-back pain, leg pain and ODI score improved significantly in both groups after surgery (P < 0.05). The VAS of low-back pain on POD 1 was significant less (P < 0.001) for Group PE. There was no statistical difference (P = 0.561) in CT fusion rates between Group PE (85%) and Group MIS (92%). No serious complication was observed in any patients. CONCLUSION: The study indicated that PETLIF had advantages of less surgical trauma, less postoperative low-back pain, less hidden blood loss, and faster recovery, compared with MIS-TLIF. There was no significant difference in medium-short term surgical outcomes between the 2 techniques. However, the indications of PETLIF is relatively limited, and the learning curve of PETLIF is deep, surgeons need to select indications strictly. Further study with big sample size and long-term follow-up is needed.
BACKGROUND: Percutaneous endoscopic transforaminal lumbar interbody fusion (PETLIF) has been used in the treatment of lumbar degenerative diseases, as a novel minimally invasive technique. OBJECTIVES: To compare the surgical trauma and the medium-short term postoperative outcomes of PETLIF and traditional minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). METHODS: From April to August of 2018, 75 patients with lumbar degenerative diseases received PETLIF (Group PE, 35 cases) or MIS-TLIF (Group MIS, 40 cases) were enrolled in the prospective cohort study. We recorded the serum creatine kinase (CK) and C-reactive protein (CRP), blood loss, visual analog scale (VAS), Oswestry Disability Index (ODI), modified Macnab criteria score, complications, and fusion rates of the 2 groups. RESULTS: There were significant reductions in CRP (P = 0.002) on postoperative day (POD) 3, and CK (P = 0.011) on POD 1 for Group PE than Group MIS. The mean true total blood loss (P < 0.001), intraoperative blood loss (P < 0.001), postoperative drains (P < 0.001), and hidden blood (P = 0.020) in the Group PE were significantly less compared with Group MIS. The VAS score for low-back pain, leg pain and ODI score improved significantly in both groups after surgery (P < 0.05). The VAS of low-back pain on POD 1 was significant less (P < 0.001) for Group PE. There was no statistical difference (P = 0.561) in CT fusion rates between Group PE (85%) and Group MIS (92%). No serious complication was observed in any patients. CONCLUSION: The study indicated that PETLIF had advantages of less surgical trauma, less postoperative low-back pain, less hidden blood loss, and faster recovery, compared with MIS-TLIF. There was no significant difference in medium-short term surgical outcomes between the 2 techniques. However, the indications of PETLIF is relatively limited, and the learning curve of PETLIF is deep, surgeons need to select indications strictly. Further study with big sample size and long-term follow-up is needed.